NHS Dentistry: Salford and Eccles

I must pay full credit to the local staff and teams across Salford: all the dentists, hygienists, therapists, nurses and administrators, and the Greater Manchester integrated care partnership’s dental commissioning team. They are giving their absolute best in incredibly difficult circumstances. However, our dental services are under unprecedented strain.

I would be grateful if the Minister addressed the following issues in his response. First, there has been chronic underfunding of NHS dental services. In real terms, net Government spend on general dental practice in England was cut by over a quarter between 2010 and 2020. It is also important to note that England invests significantly less in dental services per head of population than other parts of the UK. For example, before the pandemic Government spend on NHS dentistry per capita was £37 in England, compared with £49 in Wales, £56 in Northern Ireland and £59 in Scotland. The Minister might respond by saying that in January the Government pledged £50 million for a “dentistry treatment blitz”. However, that was a time-limited, one-off injection of funding which had very modest take-up, as practices were so overstretched in trying to hit unrealistic activity targets that they struggled to find any additional capacity. The British Dental Association estimates that it would take £1.5 billion a year just to restore dental budgets to their 2010 levels. I hope that the Minister will agree to take back a proposal to his Department for the ringfencing of long-term funding on that scale.

Secondly, the current target-based NHS dental contract is causing serious problems in the recruitment and retention of staff. The British Dental Association says that we are facing an “exodus” of dentists from the service: 75% of dentists surveyed are thinking of reducing their NHS commitments next year alone. Central to this is not only the issue of chronic underfunding that I have already mentioned, but the current discredited target-based dental contract that was imposed on the profession in 2006 and was widely considered unsustainable and unfit for purpose even before the pandemic. Indeed, in 2010 both Labour and the Conservatives committed to amending the contract. It sets restrictions on the number of NHS patients that a dentist can see, and it punishes dentists for taking on new patients with high needs.

The Minister may, of course, refer to a package of marginal changes that the Government introduced in November, including dentists’ updating a “find a dentist” website regularly with details of the availability of appointments, a higher reward for treating three or more teeth, and a new payment rate for complex treatment. While those are of course welcome changes, sadly there is little point in setting up a “find a dentist” website for appointments when the Government know that no appointments are actually available.

Furthermore, the British Dental Association states that the changes will do little to arrest the exodus of dentists from the service or to address the crisis in patient access, given that they have been introduced with no additional funding. With that in mind, I would be grateful if the Minister told me when formal negotiations on fundamental long-term reform of the dental contract are due to begin.

A constituent contacted me to express concern about the Government’s plan to go ahead with proposed changes pursuant to the recent consultation on changes to the General Dental Council’s international registration legislation despite the large number of respondents who have raised issues relating to the proposal. I hope that the Minister will take those concerns on board, and will agree to review it.

Thirdly, let me stress to the Minister that NHS dentistry must cease to be treated as an afterthought in healthcare policymaking. Changes in primary care commissioning in the Health and Care Act 2022 must not lead to further cuts, and dental services must be represented adequately in the governance structures of the new integrated care systems.

Let me finally point out that prevention is key, but has lost its way somewhat in recent years. The Government must undertake to build on historical commitments to prevention, in parallel with support for dental services. That must include supervised brushing in early years settings, dedicated funding for new water fluoridation schemes, and measures to reduce sugar consumption.

I hope that the Minister has listened to the concerns I have raised and will address each point in turn, rather than reiterating previous Government responses on what they have done so far. What the Government have done so far clearly is not working. If my constituents cannot get access to an NHS dentist across Salford and Eccles, something needs to change urgently. Access to dental treatment should be a right, not a luxury.

As I set out at the start, NHS dentistry faces an existential threat. My constituents are not receiving the access to care that they deserve. It is clear that urgent action is required. Finally, let me take this opportunity to wish you, Madam Deputy Speaker, a fantastic Christmas and a happy New Year, and the same to the Minister and all staff in the House.

Across the nation, the system is recovering and delivery of dental care is increasing. In 2021-22, 24,272 dentists performed NHS activity—an increase of 539 on the previous year. In the 12 months to 30 June this year, 5.6 million children were seen by an NHS dentist, compared with 3.9 million children in the same period the previous year. That represents a 43% increase.

Finally, to make it easier for patients to find dentists taking on new patients, we have made it a requirement for NHS dentists to update their information on the NHS website, which has historically been out of date, but of course we are looking to go further to ensure that those appointments are there. These changes are just the beginning. They are the necessary first steps of our work to improve NHS dentistry. These are the measures that we can take immediately, and they will have a noticeable impact, but we will go further.

Looking forward into the new year, we have been working with NHS England and the sector on further changes to improve access. Our priorities for this next phase of reform include: improved access to urgent care for patients who need to see someone immediately; better access to care for new patients; and further workforce and payment reform. We aim to take the necessary steps to implement these changes next year, but I am keen to seek every opportunity to take action wherever I can, and ahead of those reforms we are also actively considering what support we can offer to help patients who do not currently have access to the dental system and those who are not attached to a practice, who have the worst access. We are also considering how the recruitment and retention of dentists can be improved, particularly in the parts of the country where the need is greater. We are also thinking further about how overseas qualified dentists can be supported to start working in the NHS more quickly.

I am strongly committed to improving our NHS dental system wherever I can for all those who need it. The hon. Lady has set out a powerful case today on why we need to go further, and we will go further. I thank her for raising this important debate, and I hope that she will be reassured that although the reforms we have made so far will make a difference, they are far from being the end of the story, and that we will continue to take action to improve access to NHS dentistry across the nation.